Revenue Quality Assurance Specialist

3 weeks ago


Phoenix, Arizona, United States Sonora Quest Full time
Job Title: Revenue Trainer/Quality Control Specialist

Job Summary:

This role is responsible for identifying and evaluating quality and productivity for the Revenue Department. The successful candidate will demonstrate a strong understanding of denials, monitor complex adjustments, and evaluate team members' ability to meet satisfactory requirements of essential job functions. Additionally, they will train new employees to ensure compliance with all policies and standard operating procedures.

Key Responsibilities:

  • Track, monitor, report, and provide feedback regarding quality and production performance to department supervisor and individual team members.
  • Review ongoing processes to increase knowledge of insurance billing, aging, denials requirements, and changes.
  • Ensure internal audits and quality controls are in place in accordance with departmental policies, procedures, and applicable laws and regulations.
  • Effectively communicate with employees verbally and in writing to address training or procedural questions.
  • Process, respond to, or post correspondence, administrative requests, adjustments, transactions, and/or billing-related requests as required and in a timely manner.

Requirements:

  • High School diploma or equivalent.
  • Three (3) years' of related experience in medical billing or in a healthcare setting.
  • Comprehensive knowledge of ICD-10 coding, CPT coding, HCPCS coding, modifiers, and government and commercial payer guidelines.
  • Excellent communication, comprehension, and organizational skills.
  • Exceptional ability to provide constructive feedback to employees.

Preferred Qualifications:

  • Additional related education and/or experience.
  • Extensive knowledge of clinical laboratory operations.
  • Five (5) or more years' of related medical billing/insurance experience.
  • Extensive knowledge of ICD-10 coding as demonstrated by obtaining an American Academy of Professional Coders (AAPC) certificate, or by having successfully passed the Sonora Quest Laboratories ICD-10 certified coding examination.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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